Technology improvement are only effective when the user is skilled in the systems and interface of the tool. In addition communication between the EHR system, the physician, and the patient must be clear and frequent.
EHR Learning Curve
Although electronic health records are designed to streamline patient data and simplify the workflow of a practice, they ultimately rely on the physicians to properly utilize the data for its benefit. For an EHR system to be effectively implemented to its full potential, physicians must know how to incorporate the information into the functionality of their practices and improve the quality of the care they provide. A recent Medical Economics survey reported that 45% of physicians felt patient care had worsened in their practice since implementing an EHR system.
Dr. Jennifer Brull is a part of a small practice in Plainville, Kansas. She has been able to effectively use the features of her EHR system to increase patient care significantly, raising rates of microalbumin testing for diabetes patients from 14% to 95% and rates of echocardiograms for heart failure patients from 11% to 68%. These statistics reinforce that the benefits of an EHR system only go as far as the staff that uses them.
In order for EHR systems to become certified for Meaningful Use, they must include tools for quality reports, such as health maintenance alerts. This feature should be taken advantage of and customized to best fit the patients in the practice. Dr. Brull advocates this feature as well, stating that she was able to quickly customize many of her alerts. Doctors should be sure to take the time to complete this quick process.
Another tool includes extracting quality data, such as a list of patients with a particular illness. According to Brull, her EHR cannot go any further than that. Her practice resolved this issue by bringing in web-based registry software, which works with the EHR to produce custom reports. The registry can create a list of patients who haven’t been seen in a few months and don’t have upcoming appointments so that physicians are aware of which patients they should be contacting.
Once physicians have these reports, the next step is to get in touch with their patients. Currently, EHRs don’t have the ability to instantly contact each patient and leave them an automated message. This must still be done manually. Brull’s registry can transfer the information to an Excel file with patient contact information, from which staff can then contact them via phone or the patient portal.
Another important feature is quality reports on physician performance. Larger practices use a central server and the IT department can produce the quality report. Sharing this information about quality with those who are involved will help physicians and staff to know where they stand and understand who they can improve.
It‘s also essential that doctors are correctly entering data into their EHR. Information must be in its specified field for it to be filtered into the generated quality report. This is a hassle, but if physicians are aware of which data should be structured and which data isn’t as essential, the process is simplified. The key to improving quality in practice is improving overall communication between the EHR system, the physician, and the patient.